The Transition from adolescence to adulthood mental health services for young people with ADHD in Italy.

AimsEnsuring a successful transition to Adult Mental Health Services (AMHS) is fundamental for ADHD patients to prevent adverse scenarios in adults (e.g., psychiatric disorders, substance or alcohol abuse). Yet, most European nations do not have appropriate transition guidelines. This study aims to enquire about the current transition paths in Italy and the perceived experiences of the patients and their clinicians. MethodsThe present qualitative, observational study collected 36 interviews with young adults with ADHD who turned 18 between 2017 and 2021. Simultaneously, two questionnaires were filled in by the clinicians (both from pediatric and adult mental health services) who were involved in their transition paths. These tools collected information about the transition process, the services that cared for the young adults, and well-being indicators such as impairment in daily life, employment status, and the presence of sentinel events (e.g., critical stage accesses to the emergency room or hospitalizations). Successful and failed referrals were analyzed. ResultsA referral to an AMHS was attempted for sixteen young adults (8 before age 18 and 8 when turning 18), and 8 patients (22.2% overall) were successfully taken into the care of the AMHS. Twenty patients were not referred since it was deemed unnecessary (N=6) or because of the lack of specialized services or compliance (N=14). At the time of the interview, only nine participants were still under AMHS care. Of eleven individuals with a high need for care (identified by the level of impairment, support needs, or sentinel events), five were not followed by a mental health professional at the time of the interview. ConclusionsFor the majority of ADHD young adults, a transition path was never started or completed. While this is partly due to mild levels of impairment, in many cases it was difficult to find a service that could care for the adult patient. Only 1 out of 4 young adults are successfully transferred to AMHS care. Creating or improving evidence-based transition guidelines should be a priority of the public health system to ensure healthcare for as many patients as possible. The results of this study will converge towards the need for recommendations for the transition of services from adolescence to adulthood for young people with ADHD for Italian clinical practice.